Individual provider Active NPI

Charles L Clifton Jr., M.D.

  • Anesthesiology Physician
  • Decatur, GA
National Provider Identifier
1194764795
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
029608 Issued in GA
Practice address
2701 N Decatur Rd
Decatur, GA 30033-5918
Phone
(678) 514-1991
Fax
(678) 514-1992
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 029608 GA Primary

Addresses

Primary practice location

2701 N Decatur Rd
Decatur, GA 30033-5918

Mailing address

PO Box 551420
Fort Lauderdale, FL 33355-1420
Phone (800) 243-3839

Other identifiers 1

IdentifierTypeStateIssuer
000423431AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb Anesthesia Associates, P a Anesthesiology Past Accepting new patients
Dekalb Pain Center Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1194764795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551420",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333551420",
            "telephone_number": "800-243-3839",
            "fax_number": "954-839-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 N DECATUR RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335918",
            "telephone_number": "678-514-1991",
            "fax_number": "678-514-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFTON",
        "first_name": "CHARLES",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "029608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000423431A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.